NARROW NETWORK HEADACHE — The tradeoff between premiums and the breadth of provider networks is at the center of a debate involving federal and state insurance regulators, insurers and legislatures that’s playing out all over the country, Pro’s Brett Norman reports. Narrow provider networks contain health care costs, while expanding the range of providers could mean premium hikes. But broader networks are what some state regulators and consumer groups are calling for out of concern that enrollees in narrow network plans are struggling to access care. Insurers disagree; they figure consumers can pick plans that fit their needs, thank you very much. The one thing everyone agrees needs improvement is transparency about which doctors and hospitals are in what plans.

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-- The debate has made its way into election fights, causing a headache for Democrats like Sen. Jeanne Shaheen of New Hampshire, where the only insurer participating in the exchange this year cut out 10 of the state’s 26 hospitals. But five insurers are in for 2015, which has some experts predicting that the market will resolve the problem as competition grows. http://politico.pro/1qwndKn

Welcome to PULSE, where I’m racing through “Middlemarch” so that I can start my Pro eHealth colleague Arthur Allen’s new book “The Fantastic Laboratory of Dr. Weigl.” It’s the story of two scientists who undermined the Nazi effort against typhus. Sounds like George Eliot has some tough competition. The Washington Post’s review: http://wapo.st/WwKsXr

--Also, the 45th anniversary of Apollo 11’s landing on the moon has me wondering where (wo)man will be in the next 45 years. Send your ideas and PULSE suggestions to nvillacorta@politico.com.

“My moon, my man. So changeable and such a loveable lamb to PULSE.”

IN A NEW POLITICO POLL OUT TODAY — A majority says the Affordable Care Act should either be kept as it is (17 percent) or kept in place with modifications (38 percent). A 45 percent plurality says it should be repealed outright. The poll of 834 likely voters in competitive U.S. House and Senate races was conducted from July 3-13. Read more from the poll: http://politico.pro/1quMSTD

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MCCARTHY AND SCALISE PARALLEL PATHS TO LEADERSHIP — Kevin McCarthy and Steve Scalise have been pals since the late 1990s and now the pair is soon to be at the top of the House — with McCarthy taking over as House majority leader July 31 and Scalise as majority whip. “In separate interviews last week, the pair laid out a fresh direction for the House GOP that includes an agenda that’s less leadership driven and more inclusive of members’ desires. They envision a more strategic leadership structure, complete with a team focused on long-term legislative planning,” reports POLITICO’s Jake Sherman and John Bresnahan. But fissures will undoubtedly emerge, over Obamacare, for one. McCarthy refused to commit to a vote on a Republican alternative, while Scalise has led the charge around an Obamacare replacement. Guess we’ll have to wait and see what unfolds. The POLITICO story: http://politico.pro/1k79YND

STATE WEEK — Pro’s Sarah Wheaton has you covered with the latest from around the country — and beyond. Louisiana’s shifting to a premium-based payment model for Medicaid managed care organizations after a study showed it’s cheaper than a shared savings program. Minnesota’s shared savings Medicaid program saved the state $10.5 million in its first year, officials announced last week. More: http://politico.pro/1llcri3

DATA MINING IS DIGGING INTO YOUR HEALTH — Data mining: Is it intrusion or a smart use of big data for better health habits and coverage? The consumer may not have a choice, Pro eHealth editor Arthur Allen reports. Actuaries predict your life span. Banks track your spending habits. Now, your employer can tell whether you’ll have diabetes a year from now. And federal policy encourages businesses to use medical records, social media, credit card records and new activity tracking gadgets to tell you how to eat and exercise, to “data mine” for your own good and the employer’s bottom line. Aetna is among the companies paving the way. It’s using data analytics and interventions on its own 50,000 employees — and about 40 of the companies it insures are using them, too. The data explosion — some would say intrusion — is being fueled by trends in the private sector and by federal policies, including elements of Obamacare. http://politico.pro/WpvzG7

FORGET ABOUT THE PRICETAG OF COSTLY DRUGS, WHAT’S THE OVERALL IMPACT? — Debate about the new hepatitis treatment Sovaldi has centered around its $1,000 per pill price tag, but we ought to be looking at its overall impact on the health care system, CVS officials wrote in a commentary published in the Journal of the American Medical Association Sunday. CVS Chief Medical Officer Troyen Brennan and Chief Scientific Officer William Shrank argue that Sovaldi’s not a “per-unit cost outlier, but is a ‘total cost’ outlier because of its high cost combined with a very large population eligible for treatment.” Specialty drugs to treat other conditions are also in the works, they write, so the health care system needs to develop a comprehensive strategy to control costs, including who gets the medicine and when. The Pro story: http://politico.pro/Uju2zQ The JAMA article: http://bit.ly/1nXOS3x

THIS WEEK — Tuesday: House Energy and Commerce subcommittee on health hosts 21 st Century cures hearing on barriers to the development and delivery of new cures in Rayburn 2123 at 3 p.m.

Wednesday: E&C will also host a 21 st Century Cure roundtable on personalized medicine in Rayburn 2123 at 10 a.m.

--Ways and Means subcommittee on oversight holds a hearing on ACA tax credits in Longworth 1100 at 10:30 a.m.

Thursday: Ways and Means subcommittee on health holds a heading on the impact of the ACA on Medicare Advantage in Longworth 1100 at 10 a.m.

AHA BOARD ELECTS CHAIRMAN FOR 2016—The American Hospital Association’s Board of Trustees has voted Jim Skogsbergh, president and CEO of Advocate Health Care, to become the board’s chairman in 2016. Skogsbergh has led Advocate, the largest health system in Illinois since 2001, and before that, he was the executive vice president of the Iowa Health System in Des Moines. .

REPORT: ACA CUTS TO MEDICARE ADVANTAGE BY DISTRICT — Brett is on a roll today. He’s also got a story on a report released by conservative American Action Network today that breaks down the impact of the ACA’s $136 billion cuts to private Medicare plans by congressional district. Spending on Medicare Advantage next year will be cut about $1,540 — 13 percent — on average, according to the report. It’s super helpful to Republican candidates looking to bolster their case that Democratic support for the ACA translates into benefit cuts for seniors. Liberal analysts say that claim is unfounded and believe the cuts are justified by overspending on the program. The Pro story: http://politico.pro/1n1WAtg The report: http://politico.pro/1n6Bf1i

HIV DIAGNOSIS DOWN — The annual HIV diagnosis rate was cut by a third from 2002 to 2011, according to a study published in JAMA Saturday in conjunction with the 20 th International AIDS Conference this week. In 2002, 24 out of 100,000 people were diagnosed compared to 16 in 2011, according to the analysis of CDC data. Significant decreases were observed in almost every demographic groups with the greatest changes found in women, people aged 35-44 and people of mixed race. The bad news: diagnoses attributed to male-to-male sexual contact remained constant with increases found in younger men. The study: http://bit.ly/1rCujtD

GALLUP: SMOKERS DISLIKE CIGARETTE TAX HIKES — Shocker: Many smokers (58 percent) think cigarette tax increases in recent years are unjust, according to a Gallup poll released last week. About two in five (39 percent) think the increases are justified. The figures are flipped when it comes to restrictions on smoking in public places: 58 percent think the restrictions are justified while 37 percent disagree. Bad news is that most smokers say these policies don’t make them smoke less. Good news is the numbers suggest otherwise: 7 percent of smokers puff more than a pack a day down from around 20 percent in the 1990s. The July 7-10 poll: http://bit.ly/1jYCCQY

WHAT WE’RE READING

Being the only state without a prescription drug monitoring program is making it tough for Missouri to combat drug abuse, and it’s also attracting drug users from neighboring states, the New York Times reports: http://nyti.ms/1muWPbw

Cutting payments to doctors requires them to see more patients, often making them drivers of wasteful health care spending, a cardiologist writes in the Times: http://nyti.ms/1p04f82

The decision by a Florida jury to award a widow of man who died of lung cancer $23.6 billion in her lawsuit against RJ Reynolds Tobacco Company is unlikely to stand, Reuters reports: http://reut.rs/Wx4cKB

A CMS pilot program is studying whether it can reduce costs by exempting Medicare patients from the requirement that they must be admitted to the hospital for three days to qualify for nursing-home coverage, also from the Post: http://wapo.st/1nXQDxy